Final Exam: NUR631/ NUR 631 (Latest 2023/2024 Update) Advanced Physiology and Pathophysiology Exam Review| Questions and Verified Answers| 100% Correct| Grade A- GCU
Final Exam: NUR631/ NUR 631 (Latest
2023/2024 Update) Advanced Physiology and
Pathophysiology Exam Review| Questions
and Verified Answers with Rationales| 100%
Correct| Grade A- GCU
Q: how do you document if a man cannot retract foreskin over glans (head) of penis?
Answer:
phimosis
Q: risks for prostate cancer
Answer:
diet, African Am, >65yo, FHX
Q: man comes in with fatigue, diffuse LBP, fever, urinary retention.
Answer:
order UA. UTI?
Q: on a testicular exam there is a firm, non tender testicular mass?
Answer:
testicular cancer #1 differential
Q: Man with balanitis (inflammation of foreskin and head of penis)/what are you most
concerned about?
Answer:
underlying uncontrolled diabetes
Q: breast exam: squishy, easily palpated and moveable. What is it most like- ly?
Answer:
breast cyst
Q: ovarian cancer is most associated with what gene?
Answer:
BRCA 1
Q: what happens if pelvic inflammatory disease not treated
Answer:
infertility, fallopian tubes scarred from chronic inflammation
Q: benign uterine tumor/fibroid
Answer:
leiomyoma
Q: new lesion with depressed center and raised border. Suspect?
Answer:
basal cell carcinoma
Q: onychymycosis
Answer:
nail fungus, yellow thickening of nail. mostly toes
Q: Karposi sarcoma:. what is true
Answer:
1.vascular malignancy in AIDS/HIV patients and 2.it is seen mostly on legs. 3.Seen with drug
induced immunosuppression
Q: Tinea corporis
Answer:
ring worm. Circular lesion that is red, scaling
Q: shingles virus
Answer:
herpes zoster
Q: chickenpox virus
Answer:
varicella zoster virus
Q: if patient had chicken pox early, what are they susceptible to now?
Answer:
shin- gles; herpes zoster
Q: big collection of infected hair follicles
Answer:
carbuncle
Q: infected hair follicles; boil; suppurative inflammatory skin lesion due to infected hair follicle
Answer:
furuncle
Q: lesions that are thick, silvery, scales
Answer:
plaque psoriasis
Q: 2 things that allergic dermatitis and stasis dermatitis have in common?
Answer:
–
Inflammation of skin, red/itching
Q: skin is elevated/rounded when hurt/injured?
Answer:
keloid
Q: Newborn try to rotate hips and hips stay in contact with acetabulum but not seated well?
Answer:
subluxation
Q: radiology says there is sequestrum?
Answer:
devascularized/devitalized bone
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Where do we hold DNA inside the cell?
Nucleus
What is it called when cell’s commit suicide/programmed cell death?
Apoptosis
In carbon monoxide poisoning, what would we see and why?
Tissue damage d/t CO binding on hemoglobin preventing oxygen from being able to bind to those sites, preventing tissue oxygenation
If ph is LOW, Bicarb is HIGH and CO2 is HIGH what condition do we have?
Respiratory acidosis
How do molecules get intracellular or extracellular?
Water molecules via osmosis, other molecules via hydrostatic pressure
If a patient is vomiting a lot, what would they develop and why?
Metabolic alkalosis – they are losing all gastric acid contents and holding onto bicarb
To exam for neural tube defects in an amniocentesis, what are we looking at?
Alpha fetal protein
Why would a newborn have type 1 DM? What kind of condition is it?
Autoimmune disorder
What symptoms will someone with Trisomy 21 have?
Wide eyes, webbed neck, short stature, flat low-set ears, low nasal bridge, IQ <70
What gene is responsible for the maintenance of all other cells?
Housekeeping genes
If a patient comes in with chronic wounds that aren’t healing, what are we thinking about?
Diabetes – some underlying condition preventing proper wound healing
If a newborn does not have enough collectin proteins what kind of infection would they develop?
A respiratory infection – pneumonia
Where do B Lymphocytes grow and mature?
Bone marrow
If someone gets a vaccination or gets chicken pox from someone else, what kind of immunity do they have?
Active-acquired immunity
Why do we give rhogam?
To prevent hemolytic anema – given to Rh negative mom with Rh positive baby
Why does someone have rejection occur after an organ transplant?
T helper cells release cytokines, cytotoxins attack endothelial cells and cause tissue damage
What is happening at a cellular level in a type II sensitivity reaction?
Antibodies bind antigens on the cell surface
What is an exotoxin?
This is released by bacteria and causes you to get sick
What cells fight fungal infections?
Phagocytes, T lymphocytes
Why is it that when you are stressed you are more at risk to get sick?
Cortisol increases and causes T helper cells to be suppressed (cortisol suppresses T1 cell)
Severely stressed patient – what will we see in lab work?
Hypoglycemia
What happens if we’ve got cellular metabolism that is just not working right – what will happen?
Filled up with waste
Least likely interleukin to stimulate endothelial proinflammatory stage?
IL4
How dehydrated does a child need to be before we see low blood pressure?
10%
Why can a patient develop reperfusion injuries?
Damage due to reexposure to oxygen
Why do burn patients go into renal failure?
Myoglobin is release, and is too big for kidneys to filter
Patients need exercise to reduce risk in what kind of cancer?
Colon
What virus is linked to the development of cancer in children?
Epstein Barr Virus
Risk factors for exposure to children and the development of cancer?
Ionizing radiation, chemo, cigarette smoke, EBV
What granulocytes have vasoactive amines like histamine and where do they manifest?
Basophils – in the skin
Why would a patient develop pernicious anemia?
B12 deficiency – cannot absorb d/t no intrinsic factor
What is the role of the endothelium in clot formation?
Surface produce plasma protease inhibitors and assists in preventing clots from forming – Thrombomodulin
What will develop in aplastic anemia?
Pancytopenia – RBCs, WBCs, thrombocytes are ALL low
What kind of inherited disorder is hemophilia a?
X-linked recessive – from MOM to SON
Why will paresthesias develop in B12 deficient patients?
Myelin sheath degeneration / demyelination
What is happening in CML?
transloation of genes between 9 and 22
What is granulocytopenia?
LOW – infections will lead to death
What happens at a cellular level in a sickle cell patient? Hemoglobin S is a result of?
Valine replaces one amino acid (glutamate)
Where do we make oxytocin?
posterior pituitary
Why do we give pressors to severe shock patients?
To raise BP – vasoconstriction through ADH
What hormone regulates calcium?
PTH
What hormone level do we need to watch in a patient with small cell carcinoma of the stomach?
ADH
If someone has a low ADH, what will we give?
Desmopressin
What does hypomethylation do in tumor progression?
Increases from benign to malignant
If a patient has amenorrhea, abnormal hair growth, osteoporosis, galacteria (hyperprolactinemia) – what test would you want to do?
CT scan of head – looking for pituitary tumor
Why do diabetic patients pee so much?
Blood sugar is high and they are trying to excrete excess glucose
What is happening at the cellular level in diabetic patients causing microvascular complications?
Hyperplasia and basement membrane thickening causing microvascular damage
Why do diabetics need regular eye exams?
Retinopathy due to retinal ischemia
What are the symptoms of hypothyroidism?
Weight gain, brittle nails, dry skin, fatigue, bradycardia, constipation
As we age, we lose the sense of taste which causes?
Loss in weight, decrease in saliva and loss of appetite
Why are obese patients at higher risk for HTN?
Too much angiotensin
Damage to the pons would cause what affect?
Can’t distinguish between hot or cold objects or sharp/dull, pins/needle sensations
What part of the brain controls involuntary muscle control?
Cerebellum
If the patient smiles and only half the face smiles, which nerve is affected?
Cranial nerve #7 – FACIAL
If a spinal cord injury occurred and damaged the UPPER motor neurons, how would you anticipate recovery?
Initial full paralysis followed with possible gradual partial recovery
What separates the cerebrum from the cerebellum?
tentorium cerebelli
If there is a defect in the arachnoid villi, what would you expect to be wrong?
Too little CSF absorption
What part of the brain is responsible for focus and attention?
Pre-frontal
What kind of seizure is a patient having if there is altered LOC and a dream-like state?
Complex focal
If a patient had a CVA and were not able to feel certain objects – what is this called?
tactile agnosia
What is the theory about pain and transmission in and out of CNS?
Gate Control Theory
Which nerve fibers transmit pain signals?
Delta A
Where are the pain transmitting neurons located in the spinal cord?
Dorsal Root Ganglia
What kind of endogenous opioids do we have inside of us naturally?
Endorphins
What kind of system is affected in major depressive disorder?
The hypothalamic-pituitary-adrenal system (HPA)
What receptor is impaired in depressed patients?
Serotonin
Which electrolyte is affected in lithium toxicity?
Sodium – hyponatremia
What type of inherited disorder is Duchene Muscular Dystrophy (DMD)?
X-linked recessive
What is a normal PR interval?
Less than 0.2
What do the papillary muscles in the heart do?
Stop any backward expulsion of the AV valves
If there is an issue in the Phase 0 part of the cardiac cycle, which electrolyte imbalance do we susect?
Hyponatremia
What is Raynaud’s disease?
Vasospasms causing a lack of blood flow to distal extremities (fingers, toes)
If a patient comes in complaining of chest pain what labs do you want?
Repeat troponins – what to see the trend over 4-6 hours
If a patient has COPD and you see increased pulmonary vascular resistance – which type of heart failure is this?
Right sided
What is the most common cardiac issue in Trisomy 21?
VSD
What does a crescendo-decrescendo murmur sound like and what is it common in?
Wide, fixed splitting of S2 – ASD
How does conjugation of bilirubin happen?
Fat soluble (unconjugated) turns into water soluble (conjugated)
What do you want to order if a patient presents with projectile vomiting but no other GI complaints?
head injury – CT of head
What type of diarrhea will you have in lactase deficiency?
Watery osmotic
What is the term for bright, frank red bleeding of the rectum?
Hematochesia
What are the signs and symptoms of small bowel obstruction?
First abdominal distention, then later N/V
Which bacteria runs rampant in daycare centers?
Impetigo
What disorder do we generally see hepatic fat accumulation in the liver?
Alcoholic cirrhosis
What are the early signs of hepatitis?
Fatigue, vomiting, hyperalgesia
What is the term for incomplete fusion of the nasomedial and inner maxillary process?
Cleft palate/lip
What are the signs and symptoms of chronic hypoxia?
Barrel chest, clubbed nails, cyanosis, frothy cough
If the patient has a pleural effusion and there is transudative exudate but no symptoms, what are we looking for?
Protein stores
If a patient has ARDS, what are we on high alert for them developing?
Pneumonia
What is a patient is diagnosed with emphysema but they’ve never smoked?
Do genetic testing
Why do we worry about young infants with nasal congestion?
Nose breathers; cannot eat if they cannot breathe
Why do CF patients develop mucus plugs?
Chloride secretion is defective, too much sodium absorption
What do the natriuertic peptides do?
Inhibit renin and aldosterone
What do we test if we want to know renal function?
GFR
How does potassium and magnesium cause kidney stone formation?
Affect crystal growth
What do you look for in UA to differentiate between pyelonephritis and cystitis?
WBC casts
If a patient has blood in the urine, RBC casts, excessive proteinuria, what would you do next?
Renal biopsy
Why will patients with glomerulonephritis get soda colored urine?
From RBCs in the urine
What part of the kidney do IgGs affect in certain conditions like glomerulonephritis?
They deposit in the basement membrane
Why do we see urine reflux in kids?
Shortened uretes
If there is an urinary obstruction due to a spinal cord injury, what is this called?
Neurogenic bladder
What is the slowest to regenerate and heals the least?
Articular cartilage
What glucoprotein moves hormones and other metabolites so that our bone cells can form properly?
Bone albumin
What cells maintain the bone matrix?
Osteocytes
What is a pathological fracture?
Something in the bone is already abnormal – no trauma occurred
What do we want to check on in a patient who was found laying on the floor after several hours?
CK levels
What is happening in Paget’s Disease
Bone resorption and formation impaired
What is sequestrum?
devascularized and devitalized bone
What is ankylosing spondylitis?
Chronic inflammation causing spine and Si joints to fuse/stiffen
What is it called when a hip stays in contact with the acetabulum but is not seated well?
Subluxation
What is the term for when a skin injury occurs and heals with elevation, rounded, irregular borders?
Keloid skin
What are two things that allergic contact and stasis dermatitis have in common?
Inflammation and itching
What do we call lesions that are thick, silvery and scaly?
Plaques (psoriasis)
What is a big collection of infected hair follicles? One follicle?
Carbuncle, furuncle
If you had Chicken Pox, what do we need to educate on?
Herpes Zoster
Describe tinea corporis
Ringworm: circular lesions, red, scaling areas
What is Kaposi’s sarcoma? SATA
Vascular malignancy, associated with HIV/AIDS, seen in leg bones, drug-induced immunosuppression
Where could you see an onchymycosis?
Nail
Patient comes in with a new lesion, that has a depressed center, rolled borders on the face?
Basal cell carcinoma
What can happen if we do not treat PID?
Infertility – scarring of fallopian tubes due to chronic inflammation
What term do we use if we talk about benign uterine tumors, common uterine fibroids?
Leiomyomas
If we diagnose woman with cervical carcinomas in situ what does this mean?
Involves full epithelial thickness of cervix
Ovarian cancer related to mutation in which gene?
BRCA 1
If you were to do a breast exam and woman had squishy feeling, easily palpating areas?
Breast cysts
If you diagnose a man with balanitis what is the next thing you need to do?
Check a blood sugar – uncontrolled diabetes
If testicular exam with firm, nontender testicular mass?
Testicular cancer
A male comes in with fatigue, diffuse low back pain, fever, urinary retention what do you order?
U/A – UTI
Risks for prostate cancer? SATA
Diet, age >65, family hx, african-american
How do we document if man cannot retract foreskin over glans?
Phimosis
What does gonorrhea look like in a newborn?
Corneal ulcerations
Syphillis and bone/tissue lesions with heart failure, what stage do i have?
Tertiary (late) stage – neurosyphillis
What organism is the culprit of syphillis?
Treponema pallidum
Patient with strawberry spots on vagina and cervix?
Trichomoniasis – treat with Flagyl
Patient has gonorrhea, what do they also probably have?
Chlamydia
How to figure out due date using Nagele’s Rule?
Seven days after the first day of your last period, subtract 3 months, then add year
How do we figure out GTPAL system?
G = gravida, T = term, P = preterm, A = abortion, miscarriages, L = living children
Patient in 3rd trimester with bright red vaginal bleeding, no pain?
Placenta previa
Hx of PID, now right-sided pain, dark red vaginal discharge?
Ectopic pregnancy
NUR 631 – Final Exam